LESSON 10
INSULIN AND THE ORAL HYPOGLYCEMIC AGENTS
Section I. PHYSIOLOGY OF INSULIN
10-1. INTRODUCTION
There are an estimated 11 million individuals in the United States who have
diabetes mellitus. Many of these persons are authorized care in Army medical
treatment facilities. Because of this, you will be dispensing insulin or oral hypoglycemic
agents to these patients. The medications you dispense will not "cure" diabetes, but the
medications will make it possible for these diabetics to live a more normal life.
10-2. HISTORY OF INSULIN
The existence of insulin has been known for many years. As early as 1889,
scientists were aware of the fact that the surgical removal of an animal's pancreas
resulted in that animal's having signs similar to those associated with human diabetes
mellitus. In 1922, a human suffering from diabetes mellitus was successfully treated
with a hormonal product known as insulin. Since that time, insulin has been obtained
from the pancreases of slaughtered animals. Such insulin has allowed the millions of
persons who use insulin to continue living. Today, breakthroughs in genetic
engineering have resulted in an insulin exactly like that of humans. This new insulin is
called Humulin.
10-3. THE CHEMICAL INSULIN
Insulin is a chemical substance. It consists of 51 amino acids connected in two
chains. Because of its chemical composition, insulin is inactivated by digestive
enzymes. Therefore, it cannot be taken orally, it must be administered by injection.
10-4. ACTIONS OF INSULIN
Insulin is an enzyme. That is, it is a chemical catalyst that enhances the
processes by which the tissues of the body use glucose. Insulin impacts both the use of
glucose as fuel for the tissues and the storage of glucose (with as glycogen or as fat).
Therefore, the key word is energy. Specifically, insulin affects metabolism by increasing
the use and decreasing the production of glucose, increasing the storage and
decreasing the production and oxidation of fatty acids, and increasing the formation of
protein.
MD0807
10-3